Question
How can clinicians use mind-body techniques to affirm safety and reduce anxiety in clients?
Answer
Clinicians can support clients in managing anxiety by employing both top-down (cognitive) and bottom-up (somatic) techniques that affirm safety and foster nervous system regulation. A key top-down strategy is the use of orienting—guiding clients to look around their environment and mentally affirm that they are “safe enough.” This cognitive reframing helps update the brain's threat detection system, particularly the amygdala, which lacks contextual awareness. By naming the present moment and anchoring in concrete facts (e.g., date, location, age), clients bridge the gap between perceived and actual threat, shifting their nervous system from a defensive state to a grounded presence.
However, affirming safety isn't just about cognition; it also involves working directly with the body. Somatic strategies such as grounding exercises, breathwork, and sensory engagement provide bottom-up input to calm the physiological stress response. These techniques “show” the body it is safe by creating physical cues of relaxation and stability, complementing the “tell” of cognitive reassurances. For example, activities that stimulate the parasympathetic nervous system—like rhythmic movement, gentle stretching, or even petting an animal—can calm the body’s alarm system in ways that logic alone cannot.
Together, these mind-body approaches enable clients to recognize anxiety not as a flaw but as a normal biological response to perceived threat. Teaching clients to meet their discomfort with compassion rather than resistance or over-control is critical in helping them develop resilience. By integrating both cognitive and somatic strategies into their routines, clients can build a more adaptive relationship with anxiety and learn to regulate in the moment, rather than reacting from fear or avoidance.
This Ask the Expert is an edited excerpt from the course, From Overwhelm To Ease: OT Strategies For Anxiety Management, presented by Zara Dureno, MOT.
